Chronic Obstructive Pulmonary Disease

Key facts

• Chronic obstructive pulmonary disease (COPD) is a long-term lung condition in which the airways become inflamed and narrowed, making breathing progressively harder; it does not reverse, but it can be stabilised.
• It covers two overlapping patterns: emphysema, where the air sacs lose their elasticity, and chronic bronchitis, where the airway lining produces excess mucus. Smoking is the main cause, alongside long-term exposure to air pollution, dust, and fumes.
• Treatment combines short-acting bronchodilators like salbutamol for quick relief with long-acting bronchodilators such as salmeterol and tiotropium, often alongside inhaled steroids like budesonide or fluticasone.
• Seek urgent care if breathlessness becomes severe at rest, lips or fingertips turn bluish, or a flare fails to improve within a day or two of starting usual treatment.

What causes COPD

Tobacco smoking is the dominant cause worldwide. Long-term exposure to air pollution, occupational dust, and fumes in manufacturing or construction also contributes, as does prolonged exposure to smoke from solid fuels used for cooking or heating in poorly ventilated spaces.

Recognising the pattern of symptoms

COPD typically builds slowly over years. A morning cough producing clear or yellowish mucus, gradually worsening breathlessness on exertion, and a sensation of chest tightness are the hallmark features, and wheezing is common. Many people dismiss early symptoms as a "smoker's cough" or normal ageing, which delays diagnosis by a decade or more. Acute flare-ups, called exacerbations, cause a sudden worsening of breathlessness, increased mucus, and sometimes fever; these need prompt attention because they accelerate lung decline.

How COPD is managed

Treatment opens the airways, reduces inflammation, and prevents exacerbations. Short-acting bronchodilators such as salbutamol relieve breathlessness quickly during a flare. Long-acting bronchodilators like salmeterol and tiotropium keep the airways open throughout the day. Inhaled corticosteroids, budesonide and fluticasone, reduce airway inflammation and are often combined with a long-acting bronchodilator in a single inhaler. Theophylline tablets are an older option still used where inhaler access or cost is a barrier. Pulmonary rehabilitation, structured exercise and breathing training, improves function and quality of life beyond what medicines alone can achieve, and stopping smoking at any stage slows progression.

When to see a doctor

Seek urgent care if breathlessness becomes severe at rest, lips or fingertips turn bluish, or a flare does not improve within a day or two of starting usual treatment.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.